HEALTH CARE BRIEFING: Wilkie Seeks to Defend VA’s Virus Response

By Jack Fitzpatrick, Alex Ruoff and Brandon Lee

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More than 11,000 veterans have been diagnosed with Covid-19 and “hundreds” have died, but around three-fourths have recovered, Veterans Affairs Secretary Robert Wilkie plans to brief House appropriators at a subcommittee hearing this morning.

Thirty-one members of the department staff have died, Wilkie says in prepared testimony to the House Appropriations Military Construction-VA Subcommittee. He added that the VA is now well-staffed and well-stocked, and is treating 1,600 patients.

Wilkie will testify to the subcommittee later this morning along with three other VA officials. The department is under scrutiny for a variety of reasons, including VA doctors’ decision to prescribe hydroxychloroquine, the VA’s early struggles to obtain personal protective equipment, and lawmakers’ decision to give officials billions of dollars in additional funding.

Lawmakers provided the VA with $19.6 billion in emergency funding under the CARES Act (Public Law 116-136) and may press Wilkie on the obligation of those funds. House and Senate appropriators also have opted to exempt some veterans’ health funds from the discretionary spending caps under the Budget Control Act, highlighting their willingness to ramp up VA spending in fiscal 2021.

But Wilkie’s department has faced some skepticism. VA doctors have prescribed hydroxychloroquine—the anti-malaria treatment that President Donald Trump has repeatedly touted and claims to have taken to ward off the coronavirus—to 1,300 patients with Covid-19, officials said in a letter to Senate Minority Leader Chuck Schumer (D-N.Y.). Federal officials haven’t endorsed its use to treat the coronavirus, and researchers have linked it to deaths and heart risks.

VA facilities’ early struggles to procure enough medical supplies has also drawn some criticism. Out of 54 VA facilities, 33 had insufficient supplies, according to a Veterans Affairs Department Inspector General report in March. Deficiencies ranged from N95 masks to hand sanitizer, Jack Fitzpatrick reports.

Virus Aid Talks & Implementation

Black Universities Urge Funding to Trace Virus: Historically black colleges and medical groups run by Pacific Islanders asked lawmakers yesterday for funds to help stem the spread of coronavirus in minority communities. Researchers and college administrators asked for billions of dollars to fund programs to expand testing and contact tracing programs they say can be targeted to Americans hit hardest by the virus. They said that they’re uniquely positioned as organizations that represent these populations to address the problem.

James Hildreth, president and CEO of Meharry Medical College in Nashville, said four schools including his own want to create a consortium of black medical colleges using $5 billion in federal funds. That would boost health programs in low-income African American communities, which have seen higher rates of infection and death compared with white communities.

“We can deploy quickly, we know where to go, and we’ll be welcome,” Hildreth told the House Ways and Means Committee during a virtual hearing, the first of its kind according to committee leaders. Congress is debating how to shape the next coronavirus package and there’s been little agreement on how to address the nation’s racial disparities of Covid-19 deaths and infections. Members from both parties have called for funding to expand testing, but have previously sent the funds to states or to the federal government.

Ways and Means Chairman Richard Neal (D-Mass.) said he agrees that minority communities are in “desperate need” of better coronavirus testing and contact tracing. He cited a House-passed coronavirus package (H.R. 6800) that included $75 billion for public health departments and workforce agencies for testing and other programs as a good solution. Read more from Alex Ruoff.

$8 Billion Sought for Food Supplies: Senate Democrats are seeking $8 billion in the next coronavirus relief package to strengthen the food supply chain and provide more protective gear for food processing and farm employees. “This is to stop the logjam in the supply system and effectively get desperately needed food to families,” Senate Agriculture Committee top Democrat Debbie Stabenow (D-Mich.), who unveiled the measure yesterday, said. Mike Dorning has more.

  • Separately, House Energy and Commerce Chairman Frank Pallone (D-N.J.), in a letter to Food and Drug Administration Commissioner Stephen Hahn, asked for information on the agency’s efforts to maintain food safety and address food supply disruptions in the U.S. Read the letter here.

Cuomo Blasts Congress for Delaying Funds: The U.S. recovery can’t happen if Senate Majority Leader Mitch McConnell (R-Ky.) stifles relief for state and local governments, New York Gov. Andrew Cuomo (D) said at the National Press Club in Washington yesterday after meeting with Trump. “There is no nation without the states,” he said. “They tend to forget that in this town.”

Cuomo said the meeting with Trump wasn’t about politics: “It was about how do we supercharge the reopening, especially in New York, which has been hardest hit.” New York state has seen at least 360,000 cases of the illness. The governor, whose briefings have become closely watched nationally, is a leading advocate for more help for states. Unlike the federal government, they must balance their budgets, and falling revenue raises prospects of mass layoffs of public servants. Stacie Sherman has more.

Worker Protections: The House Education and Labor Workforce Protections Subcommittee today will host a hearing on the government’s efforts to protect workers from Covid-19.

The Path to Reopening

CDC Unveils Guidelines for Office Buildings: Employers could bring workers back to office buildings more safely with steps including improving ventilation, spacing workers apart and reducing shared objects like communal coffee pots, according to guidelines from the Centers for Disease Control and Prevention.

The recommendations issued yesterday show how office life may change. Pre-packaged, single-serve beverages may replace water coolers. Open-plan offices may see workers coming in shifts and breaks staggered to minimize gatherings. Employees will likely wear masks and bosses might be much more involved in workers’ health as daily health checks may be required to screen for illnesses.

The advice focuses heavily on office ventilation, recommending open windows and doors, HVAC units that use more outdoor air, increased air filtration and exhaust fans in restrooms. They’re phrased as suggestions, not requirements, and how many changes are made may depend on external factors, including whether windows can even be opened. Read the CDC recommendations here.

Americans Starting to Mingle: Americans hunkered down at home for nearly three months and businesses closed in order to help slow the spread of Covid-19. But a new real-time gauge of social distancing shows the nation’s economy is beginning to stir back to life once again. After spiking around mid-March, the Federal Reserve Bank of Dallas’ Social Distancing Index, which tracks the extent of physical distancing and its relationship to the economy, has begun falling as states begin lifting restrictions on business and consumer interactions.

The index uses geolocation data provided by SafeGraph to capture the amount of time that mobile devices are at home or at other locations, and how far they travel. A higher SDI indicates more social distancing efforts. As expected, areas with the largest populations are the furthest from a return to normalcy, even as infections ease nationally. Read more from Alex Tanzi and Wei Lu.

D.C. to Start Reopening Tomorrow: The District of Columbia will lift its stay-at-home order tomorrow, making the nation’s capital one of the last places in the U.S. to start opening. Prohibitions on groups of 10 or more and other limits will stay in place, said Mayor Muriel Bowser (D), who urged city residents to remain cautious. “This virus is still in our city, still in our region,” Bowser said yesterday. Read more.

Democrats Propose $50 Billion Child Care Fund: Reps. Rosa DeLauro (D-Conn.) and Bobby Scott (D-Va.) and Sen. Patty Murray (D-Wash.) announced yesterday they had introduced legislation to create a $50 billion Child Care Stabilization Fund within the Child Care and Development Block Grant program. The proposal would award grants to child care centers that reopen as workers return to jobs outside of their homes. The legislation would prioritize child care centers for underserved communities and require that centers provide relief on tuition for families struggling with payments.

More Headlines:

Testing, Treatment & Vaccine Efforts

The Challenge of Making Enough Vaccines: Billions will be clamoring for a coronavirus vaccine once one is ready, putting pressure on drugmakers and federal regulators to boost a production process that will likely take months, even years, to meet global demand. Roughly a half dozen vaccine candidates are being readied for human testing in the U.S. by year’s end. But regulatory and logistical hurdles will affect the timeline for when average Americans can get the shot, according to health-care regulatory lawyers. Read more from Valerie Bauman.

NIH Eyes Privacy-Protected Contact Tracing Tool: The National Institutes of Health is seeking recommendations from companies on how to build a phone app or other digital tool to collect data and provide coronavirus information to the public while maintaining adequate privacy protections. The office issued a request for information to explore whether industry partners could develop a contact tracing tool that would also monitor the health of people who’ve been diagnosed with Covid-19, link people to trials for therapeutics or preventative medicines, assess if individuals are ready to return to work, and calculate risks of infection.

The agency also wants the data collected from the tool to be easily shareable for research purposes. It asked respondents to address how information would be transmitted using best data standards and practices to make it accessible, while also complying with relevant privacy laws. “The collection of large digital health datasets has potential privacy implications,” the NIH said. Shira Stein and Daniel R. Stoller have more.

EPA Eyes Sewage as Tracking Method: Raw sewage may be a new element of states’ coronavirus surveillance efforts once the EPA completes a new research pilot project. The Environmental Protection Agency is investigating sewage as a possible signal of the number of both symptomatic and asymptomatic Covid-19 cases across communities. The six-month EPA pilot project, in conjunction with the city of Cincinnati, would contribute to Ohio’s growing surveillance apparatus for virus cases, Jay Garland from EPA’s Office of Research and Development said in an agency webinar. Read more from Sylvia Carignan.

More Headlines:

What Else to Know Today

FDA Sued to Ease Limits on Abortion Pill: Women’s health groups, including the American College of Obstetricians and Gynecologists, sued the FDA to allow patients to receive a prescribed abortion pill by mail rather than only in person at a hospital, clinic or doctor’s office. The restrictions on mail distribution of the drug, mifepristone, is not necessary and only increases health risks for patients during the Covid-19 pandemic, the groups said in their lawsuit, according to the American Civil Liberties Union, which filed the case in a Maryland federal court.

The suit joins others the ACLU has filed to battle abortion restrictions since the spread of coronavirus that has prevented women from being able to terminate unwanted pregnancies. Several states imposed bans by saying abortions were non-essential treatments at a time when medical resources had to be devoted to the virus. Read more from Cynthia Koons.

Public Option Plan Seen Reducing Premiums: Offering people who purchase their own health insurance the option of buying a government-sponsored plan may lower premiums as much as 27%, but it isn’t likely to substantially increase the number of people with coverage. That’s the finding of a study out today by the policy analysis research group RAND Corp., which assessed the impacts of offering a “public option”—a government-designed plan based on lower rates that Medicare or Medicaid pay doctors or hospitals—in the Affordable Care Act market. Read more from Sara Hansard.

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To contact the reporters on this story: Jack Fitzpatrick in Washington at jfitzpatrick@bgov.com; Alex Ruoff in Washington at aruoff@bgov.com; Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Zachary Sherwood at zsherwood@bgov.com; Michaela Ross at mross@bgov.com

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